Provider Demographics
NPI:1053664656
Name:CONSUMER CARE NETWORK
Entity Type:Organization
Organization Name:CONSUMER CARE NETWORK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:OGBOUMA
Authorized Official - Middle Name:OKE
Authorized Official - Last Name:ULOFOSHIO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:907-529-1572
Mailing Address - Street 1:412 FRONTAGE RD STE 80
Mailing Address - Street 2:
Mailing Address - City:KENAI
Mailing Address - State:AK
Mailing Address - Zip Code:99611-7784
Mailing Address - Country:US
Mailing Address - Phone:907-335-2008
Mailing Address - Fax:907-335-4673
Practice Address - Street 1:412 FRONTAGE RD STE 80
Practice Address - Street 2:
Practice Address - City:KENAI
Practice Address - State:AK
Practice Address - Zip Code:99611-7784
Practice Address - Country:US
Practice Address - Phone:907-335-2008
Practice Address - Fax:907-335-4673
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-19
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK1518179407251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health